Peds Ch 48 PrepU

A 10-year-old child is newly diagnosed with type 1 diabetes. The child's hemoglobin A1C level is being monitored. The nurse determines that additional intervention is needed with the child based on which result? 1. 8.5% 2. 7.5 % 3. 7.0% 4. 6.5%

1

A 4-year-old diagnosed with diabetes insipidus is being discharged. Which information below is most important to emphasize to the parents? 1. Diabetes insipidus is different from diabetes mellitus. 2. Children younger than 5 do not need to wear medical alert tags. 3. Children outgrow this diagnosis over time. 4. Only one person in the house needs to learn how to give the injections of vasopressin.

1

A child has been prescribed desmopressin acetate for the treatment of diabetes insipidus. The client and the parents ask the nurse how this drug works. What is the correct response by the nurse? 1. Desmopressin acetate is a synthetic anti-diuretic hormone that will slow down your urine output. 2. Desmopressin acetate works on your pancreas to stimulate insulin production. 3. Desmopressin acetate works to help your kidneys work more efficiently. 4. Desmopressin acetate is a synthetic form of insulin used to lower your blood sugar.

1

A child is diagnosed with hypoparathyroidism. Which electrolyte imbalance would the nurse most likely expect to address? 1. hypocalcemia 2. hyponatremia 3. hyperkalemia 4. hypomagnesemia

1

A group of students are reviewing information about oral diabetic agents. The students demonstrate understanding of these agents when they identify which agent as reducing glucose production from the liver? 1. Metformin 2. Glipizide 3. Nateglinide 4. Glyburide

1

The nurse is preparing teaching materials for a family whose child is prescribed somatropin for a growth hormone deficiency. What should the nurse instruct the parents about the administration of this medication? 1. This medication must be given by injection. 2. Hip or knee pain is an expected adverse effect of this medication. 3. This medication must be given in the morning before school. 4. This medication does not interact with any other types of medication.

1

A child with growth hormone deficiency is receiving growth hormone. What result would the nurse interpret as indicating effectiveness of this therapy? 1. growth plate closure 2. height increase of 4 inches 3. reports of headaches 4. rapid weight gain

2

An 8-year-old girl presents to the clinic for moodiness and irritability. The child has begun to develop breasts and pubic hair and the parents are concerned that the child is at too early an age for this to begin. The nurse knows that these symptoms may be indicative of what disorder? 1. neurofibromatosis 2. precocious puberty 3. pseudopuberty 4. adrenal hyperplasia

2

An infant on the pediatric floor has diabetes insipidus. Which assessment data are important for the nurse to monitor while the infant is on strict fluid precautions? 1. Temperature and heart rate 2. Urine output 3. Oral intake 4. Color of mucous membranes

2

The nurse knows that which condition is caused by excessive levels of circulating cortisol? 1. Addison disease 2. Cushing syndrome 3. Turner syndrome 4. Graves disease

2

A 15-year-old girl is brought to the clinic by her mother because the girl has been experiencing irregular and sporadic menstrual periods and excessive body hair growth. Polycystic ovary syndrome is suspected. Which additional assessment finding would help to support this suspicion? 1. Decreased serum levels of free testosterone 2. Body mass index as normal 3. Darkened pigmentation around the neck area 4. Short stature

3

A 7-year-old child who has type 1 diabetes mellitus is at school reporting a headache and dizziness. The school nurse notices sweat on the child's face. What should the nurse do first? 1. Offer the child 8 ounces of water 2. Give rapid-acting insulin 3. Offer the child 8 ounces of juice or soda 4. Give glucagon IM

3

The nurse is caring for a child who is scheduled for bone scan. It is suspected that the child has a growth hormone deficiency. Which finding would support this medical diagnosis? 1. The bone scan would show bone age to be three or more deviations above normal. 2. The bone scan would show a tumor on the child's kidney. 3. The bone scan would show bone age to be two or more deviations below normal. 4. The bone scan would show a brain tumor.

3

The nurse is preparing a child suspected of having a thyroid disorder for a thyroid scan. What information regarding the child should the nurse alert the doctor or nuclear medicine department about? 1. The child has had an MRI of their leg within the past 6 weeks. 2. The child is taking a vitamin supplement. 3. The child is allergic to shellfish. 4. The child wears a medical alert bracelet for diabetes.

3

The nurse working on a pediatric floor understands the importance of diagnosing inborn errors of metabolism early. A child with a suspected problem must have blood urea nitrogen (BUN) and creatinine testing done. Which is the purpose of these two tests? 1. Evaluate metabolism. 2. Detect changes in amino acid patterns. 3. Evaluate renal function. 4. Evaluate liver function.

3

An adolescent is having an annual physical. The adolescent has a documented weight loss of 9 lb (4.08 kg). The parent states, "He eats constantly." Exam findings are normal overall, except that the child reports having trouble sleeping, and the child's eyeballs are noted to bulge slightly. Which interventions would the nurse perform based on these findings? 1. Explain the preparation for an 8-hour fasting blood glucose test. 2. Prepare the parent for a neurology consult. 3. Explain why the child might need to schedule an eye exam. 4. Discuss preparing for a thyroid function test.

4

A nurse should recognize that which laboratory result would be most consistent with a diagnosis of diabetes mellitus? 1. a fasting blood glucose less than 126 mg/dl 2. glucose in the urine 3. a fasting blood glucose greater than 126 mg/dl 4. proteinuria

3

A child and her parents are being seen in the office after discharge from the hospital with a new diagnosis of type 2 diabetes. Which statement by the nurse is true? 1. "This will rectify itself if you follow all of the doctor's directions." 2. "Kids can usually be managed with an oral agent, meal planning, and exercise." 3. "A weight-loss program should be implemented and maintained." 4. "You are lucky that you did not have to learn how to give yourself a shot."

2

A nurse who is caring for a 7-year-old is providing client education to the child and caregiver. Which response by the caregiver demonstrates to the nurse that the caregiver understands the diagnosis of type 1 diabetes mellitus? 1. "Her body fights against the insulin." 2. "I will just feed my child healthy foods and sign her up for more sports." 3. "Her body doesn't have any insulin." 4. "We will just have our child exercise and take medicine to cure this."

3

A nurse is teaching a child with type 1 diabetes mellitus how to self-inject insulin. Which method should she recommend to the child for regular doses? 1. Intramuscularly in the abdomen 2. Intravenously in the chest 3. Intradermally in the outer arm 4. Subcutaneously in the outer thigh

4

A nurse is to see a child. Assessment reveals the chief complaints of urinating "a lot" and being "really thirsty." The nurse interprets these symptoms as being associated with which condition? 1. diabetes insipidus 2. hypopituitarism 3. precocious puberty 4. syndrome of inappropriate antidiuretic hormone secretion

1

After explaining the causes of hypothyroidism to the parents of a newly diagnosed infant, the nurse should recognize that further education is needed when the parents ask which question? 1. "So, hypothyroidism can be treated by exposing our baby to a special light, right?" 2. "So, hypothyroidism can be only temporary, right?" 3. "Do you mean that hypothyroidism may be caused by a problem in the way the body makes thyroxine?" 4. "Are you saying that hypothyroidism is caused by a problem in the way the thyroid gland develops?"

1

The nurse is caring for a child recently diagnosed with hypoparathyroidism disorder. Which medication would the nurse expect to be ordered? 1. oral calcium 2. oral potassium 3. intravenous diuretic therapy 4. oral corticosteroids

1

The nurse is caring for a 10-year-old child with growth hormone (GH) deficiency. Which therapy would you anticipate will be prescribed for the child? 1. Short-term aldosterone provocation 2. Oral administration of somatotropin 3. Long-term blocking of beta cells 4. Injections of GH

4

Which results would indicate to the nurse the possibility that a neonate has congenital hypothyroidism? 1. Normal TSH level and high T4 level 2. Normal T4 level and low TSH level 3. High thyroxine (T4) level and low thyroid stimulating hormone (TSH) level 4. Low T4 level and high TSH level

3

The nurse is planning care for a school-age child diagnosed with growth hormone deficiency. Which diagnosis should the nurse select to help the child with this health problem? 1. Ineffective tissue perfusion related to infantile blood vessels 2. Impaired skin integrity related to overproduction of melanin 3. Risk for self-directed violence related to oversecretion of epinephrine 4. Risk for situational low self-esteem related to short stature

4

A child with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. Which action would be the priority? 1. measuring urine output 2. checking vital signs 3. weighing the client 4. encouraging increased fluid intake

2

A 10-year-old client is upset and tells the school nurse. "I am the shortest one in my class. I am done with school and just want to stay home." Which response by the nurse is most appropriate? 1. "Would you like to talk with another child who has experienced what you are going through?" 2. "I know kids can be mean these days, but I am sure you will be taller soon." 3. "Let me explain to you your disorder so you understand what is going on." 4. "You seem very upset. Sit down and let's talk about what is going on."

4

A newborn is discovered to have congenital adrenogenital hyperplasia. What will the nurse most likely observe when assessing this client? 1. Abnormal facial features 2. Divergent vision 3. Small for gestational age 4. Enlarged clitoris

4

Which nursing objective is most important when working with neonates who are suspected of having congenital hypothyroidism? 1. allowing rooming in 2. early identification 3. encouraging fluid intake 4. promoting bonding

2

A 10-year-old child has been diagnosed with type 1 diabetes mellitus. The child is curious about the cause of the disease and asks the nurse to explain it. Which explanation will the nurse provide? 1. "The part of your body called the pancreas is broken and produces too much chemical called glucagon, which makes you really thirsty and have to go to the bathroom a lot." 2. "The pancreas inside your belly makes enough chemical called insulin, but your body does not want to use it to keep your blood sugar level normal." 3. "Special cells in a part of your body called the pancreas cannot make a chemical called insulin, which helps control the sugar level in your blood." 4. "The alpha and beta cells in your pancreas are fighting against each other; that is why your blood sugar stays high and you need insulin injection."

3

The nurse has told the 14-year-old adolescent with diabetes that the doctor would like to have a hemoglobin A1C test performed. Which comment by the client indicates that she understands what this test is for? 1. "The normal level for my hemoglobin A1C is between 60 to 100 mg/dl." 2. "That is the test that I take after I have fasted for at least 8 hours." 3. "This will tell my doctor what my average blood glucose level has been over the last 2 to 3 months." 4. "I monitor my own blood glucose every day at home. I don't see why the doctor would want this done."

3

The nurse is taking a history on a 10-year-old child who has a diagnosis of hypopituitarism. Which question is important for the nurse to ask the parents? 1. "Is your child taking vasopressin IM or SC?" 2. "Does your child get upset about being taller than friends?" 3. "How often do you test your child's blood glucose?" 4. "What time each day does your child take his growth hormone?"

4

The nurse is caring for a 10-year-old child with growth hormone (GH) deficiency. Which therapy would you anticipate will be prescribed for the child? 1. Oral administration of somatotropin 2. Injections of GH 3. Short-term aldosterone provocation 4. Long-term blocking of beta cells

2